Bitterest pill

There are fifty million Americans without health care insurance. Look here’s one of them, sewing up his own leg wound. Euwwwgh. Ooh, and here’s another, who, when he inadvertently chain-sawed off two fingers, had to choose whether to keep the ring finger ($12, 000) or the middle finger (a cool $60 000). That’s one expensive hand gesture.

But, Moore tells us, this film isn’t about people who can’t afford health insurance (shame – I was rather looking forward to the man who had to choose whether to save his right arm or his left leg and the woman who removed her brain tumour with a lollystick.) No, it is about the quarter of a billion people in the US who do have medical insurance but are screwed by the system anyway, by insurers who tell them that their illness is not covered by their policy, that they failed to disclose a previously-existing symptom, or that their recommended, life-saving bone-marrow treatment is "experimental".

This latest film by Moore highlights a point raised memorably in the Canadian documentary The Corporation: that once profit becomes the aim of the game, people are forgotten. Worse, Moore’s film seems to suggest, they’re left to die. In one scene in Sicko, the effects of the United States’ private health care system become disturbingly clear as a former Health Service Management (HMO) employee explains that, since denying claimants medical treatment saved the HMOs money, those employees who denied the most treatments would be awarded a bonus. This dickering over payment actually has a term: it’s called the “medical waltz.” Nice.

Once again Moore has presented this weighty topic in a very accessible manner, interspersing footage of poor, sick and worried Americans with old fashioned, nostalgic clips - the American dream laid bare next to the apparent nightmare reality.

After watching this film there can be no doubt that America’s system of caring for its people is letting them down horrifically, although, as with Moore’s previous films, his approach is problematic in that it often smacks of the duplicity, manipulation and scare-mongering of which he accuses his targets. The reason that Moore’s films are so engaging is also what makes them a little grating: he knows how to spin a compelling narrative, but there’s the nagging feeling that he knows the story he wants to tell and then hunts down the facts accordingly. Doubtless, Moore has a very important message to impart only it’s in danger of being drowned out by Adagio for strings.

So we watch as a middle aged couple unable to afford the medical bills their insurance won’t cover, moving into their married daughter’s basement room. They arrive, on camera, to a room filled with crap; there’s barely a square foot for them to inhabit. Presumably this is meant to crank up the sympathy but it feels incredibly bogus (can we seriously be asked to believe that a daughter can’t even be arsed to relocate a cabinet of action figures for her sick, homeless parents?) and you start to wonder how much of Moore’s truth you can trust.

A similar thing happens when Moore visits Britain to find out if the US government’s scare stories about a universal, "Socialist" health care system are true. With his disingenuous voiceover, he follows people around a London hospital asking, “How much did you have to pay for your baby?”, and, “where’s the cashier's office”, and “how much was your bill?”, continually faking surprise as they shake their heads and laugh at him. It gets a little wearing. And that’s without the rather too glowing portrait Moore paints of the NHS, backed by rousing trumpets. Truly, if I thought I could trust Moore’s wholly Utopian depiction of life in France, I’d be on the next plane.

But for all his heavy-handed sensationalism, Moore does get your blood flowing and despite his impression of our good old NHS, the film made me uncomfortably aware of how similar Britain is becoming to America, with our lack of NHS dentists, our tuition fees, our increasing pursuit of profit over people. Personally, I’d like to see a documentary (if not a world ruled) by Tony Benn: quite the most sensible man I’ve ever encountered who utters the most stirring words in the film: “If you can find money to kill people you can find money to help people.”

Whatever its problems, this film is a must-see. There is definitely a need for Michael Moore who is bringing these issues to the mainstream and engaging a culture, both here and over The Pond, who are more inclined to watch reality TV than march for their rights. We need to know that Americans can get medicine in Cuba for a few cents, which costs them hundreds of dollars back home. We need to know that a child dies because she is not at a hospital which corresponds to her insurance plan. Everything Moore tells us, we should be concerned about and acting on.

Alas, Moore doesn’t know when to quit and his parting shot takes the shine off somewhat. Apparently the guy who runs the largest anti-Michael Moore website was planning to close down the site because of his sick wife’s medical bills. However, the site is still up because, big man that he is, believing everyone has a right to freedom of speech, Moore sent the man an anonymous cheque for $12,000 so he could carry on slagging the filmmaker off. Well, anonymous if you don’t count announcing it to millions in your latest film, that is.

Rating: 8/10

Sicko is on general release.

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